两种大剂量乙肝疫苗对低/无应答成人再免疫效果分析  

Effects of two types of hepatitis B vaccines in large dose on non-and-low response adult during revaccination

作　　者：宋红潮[1] 熊传庆 梁绍莲[1] 郭艳秋[1] 黄泽强[1] 朱丹[1] 

机构地区：[1]广西医科大学第一附属医院预防保健科,广西南宁530021

出　　处：《中国热带医学》2016年第1期60-62,共3页China Tropical Medicine

基　　金：广西壮族自治区卫生厅公共卫生计划课题(No.Z2012114)

摘　　要：目的观察低/无应答成人接种不同剂量乙肝疫苗后乙肝病毒表面抗体(抗-HBs)阳转情况,评价两种大剂量乙肝疫苗的免疫效果。方法选择乙肝病毒表面抗原(HBs Ag)、乙肝病毒e抗原(HBe Ag)阴性,抗-HBs几何平均滴度(GMT)<100 m IU/m L的低应答成人49人、无应答成人274人为调查对象,根据知情同意、随机原则分为两组:一组为20μg组,即按0、1、6个月免疫程序接种乙肝疫苗;一组为60μg组,即接种一针60μg乙肝疫苗。免疫后3个月内复查乙肝五项指标。结果再免疫后,两组人群抗-HBs GMT分布差异无统计学意义(无应答成人χ~2=5.946,P=0.051;低应答成人χ~2=0.437,P=0.509);抗-HBs阳转成人中,GMT在10~100 m IU/m L范围的无应答成人,20μg组低于60μg组,差异有统计学意义(Z=-3.595,P=0.000);女性抗-HBs应答水平高于男性(χ~2=8.380,P=0.015);各年龄段应答水平差异无统计学意义(χ~2=8.559,P=0.200)。结论低/无应答成人接种一针60μg乙肝疫苗与全程接种三针20μg乙肝疫苗疗效相当。Objective To observe the seroconversion of hepatitis B virus surface antibody （anti-HBs）on non-and-low response adults after being revaccinated with different dosages of hepatitis B vaccine, and then to evaluate the immune effect of two types of hepatitis B vaccine in large dose. Methods A total of 49 low-response adults and another 274 non-response adults, with negative hepatitis B virus surface antigen （HBsAg）and hepatitis B virus e antigen （HBeAg）and anti-HBs geometric mean titer （GMT）lower than 100 mlU/mL, were selected as research subjects and informed consent and randomly divided into two groups. In group 20 Ixg, subjects were injected with 20 I^g hepatitis B vaccine each time following the immunization schedule of zero, first and 6th month; in group 60 txg, however, subjects were injected with 60 ~g hepatitis B vaccine just once. Three months after the full immunization process, the five indexes of hepatitis B were reviewed. Results After revaceination, there was no significant difference in the distribution of anti-HBs GMT between the two groups （non- response adults ）（2=5.946, P=O.051 ; low-response adults ）（2=0.437, P=0.509） ; Among anti-HBs positive adults, in the range of 10~100 mlU/mL, non-response adults＇ level of anti-HBs GMT in 20 Ixg group was lower than that in 60 Ixg group and the difference was statistically significant （Z=-3.595, P=0.000） ; Anti-HBs response level of female was higher than that of male after revaecination （X2=8.380, P =0.015）. Besides, the difference between immune response level among different age groups were not statistically significant （X2=8.559, P=0.200）. Conclusion To non-and-low response adults, one dose of 60 μg and three doses of 20 p.g hepatitis B vaccine efficacy was equivalent.

关 键 词：乙肝疫苗 低/无应答 再免疫 效果 

分 类 号：R186.3[医药卫生—流行病学]